Adjustable Gastric Banding

The Laparoscopic Gastric
Band is a mechanical
device that is placed around the uppermost part of the stomach in order to
form a small “pseudo-pouch” which fills with ingested food. The outlet
from the pouch is restricted by the inflatable portion of the band and can
be adjusted to slow the emptying of food. This readily allows for the
creation and maintenance of the feeling of fullness.
The Laparoscopic Gastric Band was developed
over a ten year period beginning in the 1980s. The first Lap Band was
placed in Europe around 1992, and has been extensively used since
then--especially in Europe and Australia. The LapBandTM received FDA
approval in the Summer of 2001 after a U.S. trial. Dr. Scott and Dr.
de la Torre were part of a select few bariatric surgeons involved in this
investigation. Because of this, their experience with Gastric Banding
dates back to 1999. More recently, the Realize BandTM
from Johnson & Johnson has received approval by the FDA
for weight loss.
Like other purely
restrictive procedures, the effect from the Gastric Band occurs from a decrease
in the amount of food (and calories) that is eaten at a given setting.
The sensation of fullness occurs with smaller meals. Best results are
obtained when patients eat solid foods and avoid high calorie liquids and
"junk food."

The Gastric Band is connected by
a thin flexible tube to a small reservoir or port which is placed under the
skin and soft tissues of the abdominal wall. This port is accessed by
a small needle in order to place more fluid into the band or remove some in
order to tighten or loosen the "collar" around the upper part of the
stomach.
Patients with the Gastric Band
system require multiple adjustments in order to be successful. During
these adjustments the small port under the skin will be identified.
Local anesthesia will be used to numb the area and a thin needle will be
inserted into the port to add or remove fluid as indicated to adjust the
outlet of the Band. Patients with the Gastric Band system should
expect a steady, gradual weight loss. When the band is properly
adjusted, the weight loss is approximately 1-2 lbs. per week.
Advantages
 | The Gastric Band may lead to complications of erosion into the stomach or
esophagus, requiring surgical intervention. |
 | Slippage of the lower portion of the stomach up and through the Band can
occur. |
 | There is a risk of esophageal dysmotility of dilatation |
 | Because restrictive procedures rely solely on a small stomach pouch to
reduce food intake, there is the risk of the pouch stretching. |
 | Several visits are required to fine-tune the size of the diameter of
the band opening and maintian optimal results. |
 | Some patients lose less than half their excess body weight. |
 | Leakage of fluid from within the Gastric Band apparatus may occur and
loosen the collar at the upper stomach, which can lead to weight regain. |